820683_INSPECTIONS_20171231

NORTH CAROLINA
Qepartment of Environmental Quality
--·~ _ ...... _..,._. -·~ ....... -... __ ..
ompliance lnspedion Operation Review 0 Structure Evaluation
Reason for Visit: ~tine 0 Complaint 0 Follow-up 0 Referral 0 Emergency
Date ofVisit:l o-a:--lo!.ff Arrival Time:l /0.'"5? I Departure Time:! L'J"D I County: ~.,...._ Region: Cfu
Farm Name: 1<7?1 n e ).7 Fa(' tV'--_;:p:::-.?2-= Owner Email:
Owner Name: L{ la!'("e""V'-~rrn.l..-.'2 (\1~7 Phone:
~
Mailing Address:
Physical Address:
Facility Contact: Phone:
Onsite Representative: II Integrator:
C ertified Operator: I Certification Number: £.-'-/ u-'{
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
I . Is any discharge observed from any part of the operation? 0 Yes (2S..No DNA ONE
Discharge originated at: 0 Structure 0 Application Field D Other:
a . Was the conveyance man-made? 0 Yes QNo DNA ONE
b. Did the discharge reac h waters of the State? (If yes, notify DWR) 0 Yes 0No D NA ONE
c. Wh at is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge by pas s the waste management system? (If yes, notify DWR) 0 Yes 0No DNA ONE
2. Is there evidence o f a past discharge from any part of the ope ration?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page 1 of3
0 Yes l2:) No
0 Yes g)_ No
DNA ONE
DNA ONE
214/2015 Continued
(Facility Number: loate oflnspec:tion: -y-g---;y I
. Waste Collection & Treatment
• 4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier: CJ:
Spillway?:
Designed Freeboard (in): /q--
Observed Freeboard (in): tfl3
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
0 Yes jig No 0 NA 0 NE
0 Yes 0 No 0 NA D NE
Structure 5 Structure 6
0 Yes [EJ-No 0 NA D NE
D Yes (2g No 0 NA D NE
If any of questions 4-6 were answered yes, and tbe situation poses an immediate public bealtb or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not appli cable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system oth er than the waste struc tures require
maintenance or improvement?
Waste Application
I 0 . Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
D Yes ~No D NA 0 NE
D Yes ~No 0 NA D N E
D Yes ~ No 0 NA 0 NE
DYes f2JNo 0 NA 0 NE
II. Is there evidence of incorrect land application? If yes, c heck the appropriate box be low. 0 Yes ~o 0 NA 0 NE
0 Excessive Ponding D Hydrauli c Overload 0 Frozen Ground D Heavy Metals (Cu, Zn, etc.)
0 PAN D PAN > 10% or 10 lbs. 0 Total Phosphorus 0 Failure to In corporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Approved Area
12 . Crop Type(s): 6-tz:J15-co,..,. ftj~ / 5'--:N'./.r.-.-/c ud-
. ;
13 . Soil Type(s): t.7nc b,bw7 / 6 d)s lo/U / Fo1'~.5 yr;....._ /J.Jorfbff;;:_ /7(a~ . .._ s
14 . Do the receiving crops differ fro m those des ignated in theCA WMP? D Yes ~o 0 NA D NE
15. Does the receiving crop and/or land application site need improve ment?
16 . Did the fac ility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17 . Does the facility lack adequate acreage for land application?
18 . Is there a lack of properly operating waste appli cation equipment?
Required Records & Documents
19 . Did the facility fail to have the Certi fi cate of Coverage & Permit readi ly available?
20. Does the facility fail to have all components ofthe CAWMP readily available? If yes, check
the appropriate box.
Owup 0Checklists 0 Design D Maps 0 Lease Agreements
D Yes 0-No D NA D NE
D Yes ~No DNA 0 NE
DYes ffiNo DNA ONE
DYes ~No DNA ONE
DYes ~N o DNA ONE
DYes 0--No DNA ONE
Oothe r:
21. Docs record keeping need improvement? If yes, check the appropriate box below. D Yes ~o DNA 0 N E
D Waste Application 0 Weekly Freeboard D Waste Analys is D Soil Analysis D Waste Transfers D Weather Code
0 Rainfall D Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rainfall In spect ions D Sludge Survey
22. Did the faci lity fail to install and maintai n a rain gauge? DYes ~N o 0 NA 0 NE
23. If se le cted, did the facility fail to insta ll an d maintain rainbreakers o n irrigation equipm ent? 0 Yes ~No D NA 0 NE
Poge 2 ofJ 21412 015 Continued
(Facility Number: §"..:z_ -f.? f:3 I Date of Inspection: ::>-~;?o I ar
, 24. Did the facility fail to calibrate waste application equipment as required by the permit? •
25. Is the facility out of compliance with permit condi tions related to sludge? If yes, check
the appropriate box(es) below.
DYes [l~No DNA 0 NE
DYes (29.No 0 NA D NE
0 Failure to complete annual sludge survey 0Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31 . Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Application Field 0 Lagoon/Storage Pond D Other:
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
Reviewer/Inspector Name:
Reviewer/Inspec tor Signature:
Poge3of3
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes [21No DNA ONE
DYes k3J.No D NA O NE
DYes ~No DNA ONE
DYes ~No D NA ONE
DYes 0No DNA ONE
D Yes [3._No DNA ONE
D Yes ~0 DNA ONE
Phone: 'l/l>-3?)3 -<!J IS7
Date: pJ--1&-?f?J/ r
21412 015
Reason for Visit:
Co~liance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
<3"Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: laJ '54/JI Arrival Time:l1!tvlf
••
Farm Name: K ~<A:(l ~. ,F"(..I:\.t # Z.
Owner Name: /A)I{,Ne-n._ f«.cr~ Co
Departure Time:l/otft)ft I County: JkYI{ Region: p1Z0
Owner Email:
Phone:
Mailing Address:
Physical Address:
Facility Contact: ~oll"l ~ W • q,'-"-'11:1 Title: Phone:
Onsite Representative: _____ [_, ______________ _ Integrator: f1t6 £' ~ -&.P·.Je?
Certified Operator: Certification Number; IL.fh--'(.::....:....f..::6J:...._ _____ _
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? DYes 8-N"o DNA ONE
Discharge originated at: D Structure 0 Application Field D Other:
a. Was the conveyance man-made? DYes 0No ITNA ONE
b. Did the discharge reach waters ofthe State? (If yes, notifY DWR) DYes 0No (3'NA ONE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notifY DWR) DYes 0No [?A ONE
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page I of3
DYes
DYes
(3'"'"No DNA ONE
LJNo DNA ONE
11412015 Continued
!Facility Number: rf;2 -/4t1 Jnate of Inspection: fil.3 ~ l?
I
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural fi"ceboard?
Structure 1 Structure 2 Structure 3 Structure 4
identifier:
Spi11way?:
Designed Freeboard (in):
Observed Freeboard (in): £.i8
0Are there any immediate threats to the integrity of any ofthe structures observed;!
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes~ DNA
DYes 0No ~A
Structure 5 Structure 6
ONE
ONE
[ff'Yes 0 No D NA 0 NE
DYes ~o DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
~o any of the structures need maintenance or improvement? ~s 0 No D NA 0 NE
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
1 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes [d-No DNA 0 NE
DYes [3"No DNA 0 NE
0 Yes J3"No DNA 0 NE
11. Is there evidence of in correct land application? If yes, check the appropriate box below. 0 Yes Ga"No D NA 0 NE
0 Excessive Ponding D Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
D PAN D PAN> 10% or 10 lbs. 0 Total Pho sphoru s 0 Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Application Outside of Approved Area
12 . Crop Type(s):
13. Soil Type(s):
14. Do the receiving crops differ from those designated in theCA WMP?
15. Does th e receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettabl e
acres determination?
Pagel of3
0 Yes
DYes
0 Yes
0 Yes
0 Yes
0 Yes
0 Yes
00ther:
0 Yes
~No DNA ONE
~0 DNA ONE
Ga"No DNA ONE
[2f"No DNA ONE
~No DNA ONE
c:(No DNA ONE
@'No DNA ONE
!Z(No
214/2015 Continued
•
!Facility Number: ~;::::: -lf:1 ~ate oflnspection: ;Lf r=;;;{> 1/1
J
24. Dfd the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
0 Yes g.N"o
0 Yes C}No
DNA ONE
DNA ONE
D Failure to complete annual sludge survey 0Failure to develop a POA for sludge levels
D Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notifY the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
D Application Field 0 Lagoon/Storage Pond D Other:
{jj-. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
DYes 0'No
DYes ~0
DYes ~0
DYes ~0
DYes ~0
DYes [2f'No
!B"Yes ~0
0 Yes [2fNo DYes~
DNA
DNA
DNA
DNA
DNA
DNA
DNA
DNA
DNA
~~,~~enu (refer to question f#):. ~~!B~~!,IJ, an.Y;t~~-~~~~~f~~ :andJor any additional reC()IDJDendations or any other ~~~~~ ····
Us'e drawings offacility to betteiie~plain situations (iise'adilitional pages as necessary). ·· j:,·:,·.:;'; ~ ·
c_;L b~CM C{-( 5 -{b
sc~,~ s4 b-J..'-fb-o -I{ o P-lf.5
crto-3or-b rs'
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Phone: l( SJ--3JJ '{
Date: ~fcbl]
Page3 of3 214/2015
Type of Visit: 0€ompliance Inspection Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: ORoutine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Other 0 Denied Access
Date of Visit: I fO y4& Arrival Time: I I II lbA
Farm Name: /(;;'1'1{/) Ykt ~ ::/(.: 2
Departure Time: I pI f\) 4;1 County: 5'1\:~ Region:-~
Owner Email: -----------------
Owner Name: LA )lll.d ~V\. r.ul{.t. ~, ~ Phone:
(/
Mailing Address:
PhysicalAddress: _____________________________________________ __
Facility Contact: b..(_~(. l() 1 tJ.. ""VL-':fitle: ---------Phone:
Onsite Representative: /t ------------------------Integrator: -~v'f....l..._t[,L.. _________ _
Certified Operator: II Certification Number:
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation? DYes~ DNA ONE
Discharge originated at: 0 Structure 0 Application Field 0 Other:
a. Was the conveyance m an-made? DYes 0No ff'NA ONE
b. Did the discharge reach waters of the State? (lfyes, notify DWR) DYes 0No ~ ONE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR) DYes 0No ~A ONE
2. Is there evidence of a past discharge from any part of the operation?
3 . Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page I of3
DYes
DYes
~E'JNA ONE
~DNA ONE
21411014 Continued
!Facility Number: /ib -?91 lnate oflnspection: /o Jt§C'4 /6
Waste CoUection & Treatment
4. Is storagt! capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a . If yes, is waste level into the structural freeboard?
Structure 1 Structure2 Structure 3 Structure4
Identifier: 41:·'}
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in): __.)..~{4'---
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes [31jo DNA D NE
D Yes [3"'No D NA D NE
Structure5 Structure 6
0 Yes i:2(No DNA 0 NE
DYes v;:tNo 0 NA 0 NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement? ~ 0 No D NA D NE
8. Do any of the structures lack adequate markers as required by the permit? 0 Yes [2f'"No DNA 0 NE
(not applicable to roofed p its , dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes ~No DNA ONE
DYes ~No DNA ONE
II. Is there evidence of incorrect land application? Ifyes, check the appropriate box below. 0 Yes l2j No 0 NA 0 NE
0 Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN > 10% or 10 lbs. 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Approved Area
12.CropType(s): f>e.t~U-~ f" (o.r.ll.
13. Soil Type(s)' :t: G--o F.,..-.feu g.,:...,.
14. Do the rece iving croPSiffer from those designated in the CAWMP?
15 . Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
Page 2 of3
DYes
DYes
DYes
DYes
DYes
DYes
0 Yes
00ther:
DYes
~0
~0
[!3"No
(31Jo
[3"No
[3"'No
~0
~0
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
2/412014 Continued
!Facility Number: I Date oflnspection: /~ "t((-u ( /{2 I
24. Did the facility fail to calibrate waste application equipment as required by the permit? .. -
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
D Yes [!J'No D NA D NE
DYes ~o DNA ONE
0 Failure to complete annual sludge swvey D Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first swvey indicating non-compliance:
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30 . Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems , over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
DYes ~No
DYes ffNo
DYes ~o
DYes []{'No
DYes ~o
DYes UJ'No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
0 Application Field D Lagoon/Storage Pond D Other: ----------------------
32 . Were any additional problems noted which cau se non-compliance of the permit orCA WMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
DYes ~o DNA ONE
D Yes E:J'No D NA D NE
DYes ~o DNA ONE
~ 1 /Jed -/., ed..bG:cL.. V"'J-(..{-,,._CPve~ ~ 1~7""" ~k"C..
rz~ \(,Loc..-'1:-o lJ> tt&v
c, '1. ct,., +L<P""
9,~-c_ ~
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page3 of3
Phone : ~33 -333f
Date : f QfU._~ fb
214/1014
Date of Visit:
Farm Name: ~~--~~--T---~~~~-------------
Owner Name: W ar{l/'"0"\.. h-\/V1 t'J 4, Phone:
Mailing Address:
Physical Address: ----------------------------------------------------------------------------------
Facility Contact: Pbooe:
Onsite Representative: Integrator: -----'ft{----'l3=----------
Certified Operator: 1/ Certification Number: ?J{IS3
Back-up Operator: Certification Number:
Location of Farm: Latitude: Longitude:
Discharges and Stream Impacts
1. Is any discharge o bserved from any part of the operation? DYes ~DNA ONE
Discharge originated at: 0 Structure 0 Application Field 00ther:
a. Was the conveyance man-made? DYes 0No erNA ONE
b . Did the discharge reach waters of the State? (If yes, notify DWR) DYes 0No o-w: ONE
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does the discharge bypass the waste management system? (If yes, notify DWR) DYes 0No crNA ONE
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page 1 of3
DYes
DYes
[3--No DNA ONE
Bifu DNA ONE
2/412014 Continued
lf~cilitx,Number:
Waste Collection & Treatment
I nate oflnspection: /fr lflfj 15 I
l
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure2 Structure 3 Structure4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~DNA ONE
DYes DNo ~ ONE
StructureS Structure 6
DYes rni"' 0 NA 0 NE
DYes ~ DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWR
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes
DYes
DYes
DYes
~ DNA ONE
~ DNA ONE
~ DNA ONE
~ DNA ONE
II. Is there evidence of incorrect land application? If yes, check the appropriate box below. 0 Yes ~ 0 NA 0 NE
0 Excessive Ponding D Hydraulic Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN> 10% or 10 lbs. 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outs ide of Approved Area
12. Crop Type(s): C lJJ3
13. Soil Type(s): C-0
14. Do the receiving crops di r from those designated in theCA WMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, ch eck
the appropriate box.
0WUP Ochecklists 0Design 0 Maps 0 Lease Agreement s
DYes 8No DNA
DYes ~0 DNA
DYes ~0 DNA
DYes ~ DNA
DYes ~ DNA
0 Yes t~tNo DNA
DYes G}-MO DNA
Oother:
ONE
ONE
ONE
ONE
ONE
ONE
ONE
21. Does record keeping need improvement? Ifyes, check the appropriate box below. DYes ~ DNA ONE
0 Waste Application 0 Weekly Freeboard D Waste Analysis 0 Soil Analysi s 0 Wa st e Transfers 0 Weather Code
D Rainfall 0 Stocking 0 Crop Yield 0 120 Minute Inspections 0 Monthly and 1" Rainfall Ins pections 0 Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? 0 Yes E]No 0 NA 0 NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? 0 Yes ~o 0 NA 0 NE
Page 2 of3 21412014 Continued
lk!ctlity ~umber: r~~ ru I I Date of Inspection: 91'~ 75 I
r ~
24 . Did the facility fail to calibrate waste application equipment as required by the permit? 0 Yes 4:2:1 No
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check 0 Yes ~
the appropriate box(es) below.
0 Failure to complete annual sludge survey DFailure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-<:ompliance :
26. Did the facility fail to provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29 . At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30 . Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31 . Do subsurface tile drains exist at the facility ? If yes, check the appropriate box below.
DYes
DYes
DYes
DYes
DYes
DYes
0 Application Field D Lagoon/Storage Pond 0 Other: ------------------------
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
33 . Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34 . Does the facility require a follow-up visit by the same agency'?
Ccvt~b{k__f ,·.:>V1 r-/ (-( o-( Y
£:' { u_ ~ -e_ Sv.J-._., -tJ---I '1 ,.. I'{
DYes
DYes
0 Yes
~
I:J"No
~
~
~
~
~0
[J1'Io
[2]No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
Reviewer/Inspector Name: -~.......,"-~ \,;....:(~,,D~'-.::..tA...:..~~f'f=+-=::....._---------------­
Reviewer/lns pector Signature: _t>......,'-'''""~t'--+D""=',u(~,.as.r..~..:...loo=.:f--------------------------­
PageJ of3
Phone : q33-320f
Date~IS
214110 4
Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit: 0 Follow-up 0 Refer ral 0 Emergency 0 Otber 0 Denied Access
Date of Visit: _,. t: ~l{ 1 LYlJ>u{fp Arrival Time:.._ILD.._r..,{"""o _ ___, Departure Time: I /1 ' c/6 Regionf5(!l'J
Farm Name: __ /(;.....,_c_q'-"-~......;;...-t-.a....fi,-=--"-'l.-.!l[!....__b ______ _ Owner Email:
Owner Name: tJ a,.~ 'f:<v-c.u._ c1f 6, Phone:
Mailing Addres s:
Physical Address: --------------------------------------------------------------------------------------
Facility Contact:
Onsite R epresentative: l(
Certified Operator:
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
I . Is a ny discharge observed from any part of the operat ion?
Discharge originated at: 0 Structure 0 Appli cation Fie ld
a. Was the conveyance man-made?
0 Other:
b . Did the discharge reach waters of th e State? (If yes, notify DWQ)
c. What is the estimated vo lume that reached waters of the State (gall ons)?
Pbone :
Integrator:
Certification N u~ber: 7___;;'{_/....::SJ~-------
Certification Number:
Longitude:
D Yes ~DNA ONE
D Yes D~A ONE
DYes 0 No ~ O NE
d. Does the discharge bypass the waste managemen t system? (If yes, notify DWQ) D Yes 0No ~A O NE
2. Is there evidence of a past disc harge from any part of the operation?
3. Were there any o bservabl e adverse impacts or potent ia l adverse impacts to the waters
of the State other than from a disc harge?
Page 1 of3
D Yes
0 Yes
~0 D NA O NE ~0 DNA ONE
21411011 Continued
IFacflity Number: 8"2; I Date of Inspection: J '0 / I
• Waste CoUection & Treatment
4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
Identifier:
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~NA ONE
DYes 0No ~A ONE
Structure 5 Structure 6
DYes~ DNA ONE
DYes ~ DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the penn it?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Doe·s any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes c;;}K<) DNA 0 NE
DYes ~DNA ONE
DYes ~DNA ONE
DYes ONE
II. Is there evidence of incorrect land application? If yes , check the appropriate box below . DYes
~DNA
~DNA ONE
0 Excessive Ponding D Hydraulic Overload D Heavy Metal s (Cu, Zn, etc.)
0 PAN 0 PAN> 10% or 10 lbs.
D Outside of Acceptable Crop Window
12. Crop Typc(s): e
13. Soil Type(s):
14. Do the receiving crops differ from those designated in theCA WMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Required Records & Documents
19. Did the facility fail to have the Certificate ofCoverage & Permit readily available?
20. Does the facility fail to have all components of the CA WMP readily available? If yes, check
the appropriate box.
DYes
DYes
DYes
DYes
DYes
DYes ~
DYes ~
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
OWUP 0Checklists D Design D Maps 0 Lease Agreements Oother: _________ _
21. Does record keeping need improvement? If yes, check the appropriate box below. DYes ~o DNA D NE
D Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis D Waste Transfers D Weather Code
D Rainfall D Stocking D Crop Yield D 120 Minute Inspections 0 Monthly and I" Rainfall Inspectio~/D Sludge Survey
22. Did the facility fail to install and maintain a rain gauge? DYes 0 Ng DNA D NE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes ~ 0 NA D NE
Pagel of3 21412011 Continued
!Facility Number: !Date oflnspection: JOn/'( I
~4. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
D Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
D Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge? DYes
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification? DYes
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document DYes
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern? DYes
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the DYes
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? Ifyes, check the appropriate box below. DYes
D Application Field 0 Lagoon/Storage Pond 0 Other: ------------------------
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes
34. Does the facility require a follow-up visit by the same agency? QYes
)l~v._ ~-~ I~-?-o -J-c CJ 0-~,{).
P-q,_s
~c~v.-t oU ~~~
Reviewer/In spector N ame:
[&?o" D NA
~ DNA
~ DNA
~ DNA
~DNA
~DNA
~0 DNA
[31fo DNA
~0 DNA
Revie wer /Ins pecto r Si g na ture :
Pagel ofJ
Date 3o~~~
11412011
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
ONE
Date of Visit: 1\)\,3) p.l Arrival Time:l fi.l{fAm,l Departure Time:I/;J.ttrj!!B County:~Af!\~ Region: [f.O
Farm Name: \\t(\ OE.O'f teRm~ ~ Owner Email:
Owner Name: \Jp.(\(\~ lAR~~ Co(V':.'f>f\-f\\....\ Phone:
Mailing Address:
Physical Address: -----------------------------------------------------------------------------------
Facility Contact: \\ CX\f\A,£., \.J l.\\rf\oS Title: -------------------------Phone:
Onsite Representative: __ S-.JP..~ft'..:...;.._L ____________________________ _
Certified Operator: \\\. )~ £ {\_ \ \Jei''l\!\
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at: 0 Structure 0 Application Field
a. Was the conveyance man-made?
0 Other:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
-Integrator: tt\ U ~"{
Certification Number:
Certification Number:
Longitude:
DYes CXJ No
DYes 0No
DYes 0No
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes 0No
2. Is there evidence of a past discharge from any part ofthe operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a di sch arge?
Page 1 of3
DYes El] No
DYes []No
1Sa.owf\
DNA ONE
lXJ NA ONE
6ZJ NA ONE
~NA ONE
DNA ONE
DNA ONE
214/1011 Continued
\ ..
J Facility Number: {Date of Inspection: lp \ l~ I 'l.
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1
Identifier: Jl q --=--=----
Spillway?:
Designed Freeboard (in): -~:....5 ....... · __
Observed Freeboard (in): g_cr;
Structure 2 Structure 3 Structure4
5. Are there any immediate threats to the integrity of any of the structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~No DNA ONE
DYes ~No DNA ONE
Structure 5 Structure 6
DYes ~No DNA ONE
DYes [ENo DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes ~N~ DNA ONE
DYes ~No DNA ONE
0 Yes l52' No 0 NA D NE
DYes ~No DNA D NE
II. Is there evidence of incorrect land application? If yes, check the appropriate box below. DYes IXJ No DNA 0 NE
0 Excessive Ponding 0 Hydraulic Overload D Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN D PAN> 10% or 10 lbs. D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window D Evidence of Wind Drift D Application Outside of Approved Area
12. Crop Type(s): C.t>Bf\ ·.'. bx A-\, ~~5 1 \~c:-\cut. 5\C'\C'\Ufi\
13. Soil Type(s): ~(\.~UQ.% ,G t.? {+ \ ~c::>R.~D\ Bfn-1' S, )::\.tJ i"
14. Do the receiving crops differ from those designated in the CA WMP?
15. Does the receiving crop and/or land application site need improvement?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres determination?
Page 2 of3
DYes
DYes
DYes
DYes
DYes
DYes
DYes
00ther:
DYes
00No DNA ONE
' OCJNo DNA ONE
[iJ No DNA ONE
~No DNA ONE
ltJ No DNA ONE
&J No DNA ONE
IIJ No DNA ONE
IX] No
21412011 Continued
!Facility Number: jnate oflnspection: lo\t3\ l "l..
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check
the appropriate box(es) below.
0 Yes ~ No 0 NA 0 NE
0 Yes IXJ No 0 NA 0 NE
D F.ailure to complete annual sludge survey D Failure to develop a POA for sludge levels
D Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes, check the appropriate box below.
0 Application Field D Lagoon/Storage Pond D Other:
D Yes ~ No D NA 0 NE
0 Yes [XI No DNA 0 NE
D Yes ~ No D NA 0 NE
DYes IXJ No DNA 0 NE
0 Yes IXJ No 0 NA 0 NE
0 Yes tiJ No D NA 0 NE
-------------------------
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Does the facility require a follow-up visit by the same agency?
Reviewer/Inspector Name:
Reviewer/Inspector Signature:
Page3of3
DYes ~No DNA ONE
D Yes 00 No 0 NA D NE
DYes 00 No DNA D NE
Date: -----------------
l/412011
Type of Visit: ~Compliance Inspection 0 Operation Review 0 Structure Evaluation
Reason for Visit: &Routine 0 Complaint 0 Follow-up 0 Referral 0 Emergency 0 Denied Access
Date ofVisit: fjl¥lf'IJ I Arrival Time:rt;,x?Af'(
Farm Name: ke,n~ £atm#~
Owner Name: 'rvau(h Pntm1>y Co
Mailing Address:
Departure Timeds;ooPR' I County:~,.O,
Owner Email:
Phone:
Physical Address: \s9y-Pteo~ H-eN"! Y?.L J fa lJtr}
Region: fJRo
Facility Contact: R0nnk. h-fflt'(k f Title:---------~ Phone:
Ons;te Representat;veo R(}JIJ /e lv{l/i' fht.( IntegraL;;'~ J"'vr fJ /!,roP-~
Certified Operator: Rvp± 6, \v ()(lPQ Certification Number: ...Jiw9L.;f..J'f.:..) _____ _
Back-up Operator:
Location of Farm: Latitude:
Discharges and Stream Impacts
I. Is any discharge observed from any part of the operation?
Discharge originated at: D Structure 0 Application Field
a. Was the conveyance man-made?
D Other:
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Certification Number:
Longitude:
O Yes ijSt No
DYes 0No
D Y es 0 No
d. Does the discharge bypass the waste management system? (If yes, notify DWQ) DYes 0No
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any observable adverse impacts or potential adverse impacts to the waters
of the State other than from a discharge?
Page 1 of3
DYes ~No
DYes ~No
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
21412011 Continued
, I Facility Number: ~C)., I Date of Inspection:q/d of//
Was te Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure 1 Structure 2
Identifier: _qJ...._ __ _
Spillway?:
Designed Freeboard (in):
Observed Freeboard (in):
~IS 'lGmfOiP>I~~J
3(2
Structure 3 Structure 4
5. Are there any immediate threats to the integrity of any ofthe structures observed?
(i.e., large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a
waste management or closure plan?
DYes ~No DNA ONE
D Yes 0 No D NA 0 NE
Structure 5 Structure 6
DYes 1?3} No 0 NA D NE
0 Yes fEJ No 0 NA D NE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the structures lack adequate markers as required by the permit?
(not applicable to roofed pits, dry stacks, and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance or improvement?
DYes ~No 0 NA D NE
D Yes l8J No 0 NA D NE
0 Yes 18] No DNA 0 NE
0 Yes ~ No D NA D NE
11. Is the re evide nc e of incorrect land application? If yes, check the ap propriate box below. 0 Yes D No D NA D NE
D Excessive Ponding D Hydraulic Overload 0 Frozen Ground D Heavy Metal s (Cu , Zn , etc.)
0 PAN D PAN > 10% or 10 lbs . D Total Phosphorus D Failure to Incorporate Manu re/S ludge into Bare Soil
0 Outside of Acceptable Crop Window D Evidence of Win d Drift D Application Outside of Approved Area
12. Crop Type(s); CQ.Il, )v~ai.J so, be®~ h-en~ Allll'11/
13. Soil Type(s): ftxe~ \.s ~ 6ddJD(fO ls GoA · Lvnc~os/
7 7 r J :J ~It ls M>A; ~ s I PtL
14 . Do th e receivin g crops differ from tho se designated in-theCA WMP?
15 . Does the receiving crop and/or land application site need improvem en t?
16. Did the facility fail to secure and/or operate per the irrigation design or wettable
acres detennination?
17 . Does the facility lac k adequate acreage for land application?
18. Is th ere a lack of properly operating waste application eq uipme nt?
Required Records & Documents
19. Did the facility fail to have the Certificate of Coverage & Penn it readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropriate box.
Owur Ochecklists 0Des ign D Maps D Lease Agreements
D Yes I}G No D NA
DYes ~No
DYes ~No
0 Yes I8J No
DYes ~No
DYes ~No
DYes ~No
Dot her:
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
DNA ONE
21. Does re cord keepin g need improvemen t? If yes, check the appropriate box below. 0 NA D NE
D Waste Application D Weekly Freeboard D Waste Analysis D Soil An alys is D Waste Transfers D Weather Code
D Rainfall D Stocking 0 Crop Yield D 120 Minute In spections D Monthl y and I" Rainfall Inspections 0 Sludge Survey
DYes '&JNo
22. Did the facility fail to install and maintain a rain gauge? D Yes [)SJ No 0 NA D NE
23.lfselec ted. did th e fac ility fa il to in stall and maintain rainbreakers on irri gation equipment? D Yes D No ~ NA 0 NE
Page2of3 2141201 I Continued
.11\acili~ Number: ~ -~Z3 I Date of lns~ection: ql~~d 11
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes ~No DNA ONE
25. Is the facility out of compliance with permit conditions related to sludge? If yes, check 0 Yes ~No DNA ONE
the appropriate box(es) below.
0 Failure to complete annual sludge survey 0 Failure to develop a POA for sludge levels
0 Non-compliant sludge levels in any lagoon
List structure(s) and date of first survey indicating non-compliance:
26. Did the facility fail provide documentation of an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessments (PLAT) certification?
Other Issues
28. Did the facility fail to properly dispose of dead animals with 24 hours and/or document
and report mortality rates that were higher than normal?
29. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately.
30. Did the facility fail to notify the Regional Office of emergency situations as required by the
permit? (i.e., discharge, freeboard problems, over-application)
31. Do subsurface tile drains exist at the facility? If yes , check the appropriate box below.
0 Application Field 0 Lagoon/Storage Pond 0 Other:
32. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
33. Did the Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
34. Docs the facility require a follow-up visit by the same agency?
Reviewer/Inspector Nam e:
Re v iewer/Ins pector Signat ur e:
Page 3 of3
DYes ~No DNA ONE
0 Yes 0No ~NA ONE
0 Yes ~Sa' No DNA ONE
DYes ~No DNA ONE
0 Yes ~No DNA ONE
DYes ~No DNA ONE
DYes g}No DNA ONE
DYes ~No DNA ONE
0 Yes ~No DNA ONE
Phone : Cfl rr433~3Joofoift'te}
Dat e: Sat ;;>q :cl 0 I I ,;
21412011
' . Facility No. ~ l3 Farm Name ---c_}{,_,._t'4'}LllnerJp~'--'-#-_:___:;J.-.:....,:__ __ Date q/ ~q{ /1
Permit ./ COC .__..., OIC_ NPDES (Rainbreaker PLAT Annual Cert)
Pop. Design Current
Type
Lagoon
Spillway
Design freeboard
Observed freeboard (in}
Sludge Survey Date
Sludge Depth (ft)
Liquid Trt. Zone (ft)
Ratio Sludge to Treatment Volume
Calibration Date 1 ~)-i'\
Design Flow
Actual Flow
Design Width
Actual Width
Soil Test Date ~In Ito
pH Fields ·
Lime Needed 6-1 X j
Lime Applied
Cu-I ~Zn-1 ..../"
Needs P
Crop Yield v
2
FB
1 2
illt?ltc
4.)...
~·>
'-l)
3 4
Wettable Acres ;,_/"
WUP ../
Weekly Freeboard _L_
1 ill Inspections -../
120 min Insp. v
Weather Codes J
Transfer Sheets () lr-.,
I I I I
3 4 5 6 7
5 6 7 8
RAIN GAUGE
Dead box or incinerator __ _
Mortality Records
Waste Analysis Date <ii·/10 j I I 7111111 i.Jb{)}J I ~J/Jtl/1 1-:-t I no. I J n I lJII'llln t, ltt./h
-60 Day
+ 60 Dav
N Amt (lb/1000 Gal) },) 1.-) ;_;:, 1-r
pH
Pull/Field Soil Crop Acres II~ PAN
I llv fi.JW/s!Ji6 4.7 71ffl1ff 1t..b1 IS~
\A I~A 4,~ l~lrb/14'1
IR ~A-5t{o ~
It Fn .5"-J II~ IIYII"R
lD Th 5// -lr
It? ~ ll l II~ ~J l?i)
~ ~ l:l./ ~ 1~: /14.3
I~ }?) .JJ 11/o I~ 1133
\(, h) '1,~ \
Itt \1) U.,l '\}"'
A\1 P'i~ $4WA 5() ...
FRO or Farm Records fb--
Lagoon#
Venfy PHONE NUMBERS and aff1hat1ons
Date last WUP FROf/fHios-Date last WUP at farm
s~
G:> bticy ~f ·erl-
Top Dike _if 1 Stop Pump i.N<
Start Pump \({ ·
Conversion-Cu-I 3000= 108 lb/;c; Zn-1 3000= 213 lb/ac
C~tcit. ~, :itt+r ~ C.~tt~~,L
l-:.t .~) L:l
Window Max Rate MaxAmt
(}y "-J.w"*' /hs-f ,O
Nh-rf!.-A~t"
-!i:n-~~-~ ~~
htA_-~
V II
1£1 v
A p p. Hardware
Type of Visit 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit <9'"'R'O'Utine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access
Date of Visit: I fJ-10-IO I Arrival Ti.med9:..?5A-I Departure Time: ls.·zo.n.,l County: _>e;y:r~IV , Region: Fi'Zo
Farm Name: K~HNJ'7 H. ... .--#<. OwnerEmail: -------------
Owner Name: /.,JA.rr~ ~YI>1.1N;; a~"''1 Phone:
Mailing Address:
Physical Address:-----------------------------------------
Facility Contact: PboneNo: ________ _
Onsite Representative: ------------------
Certified Operator: "'RoNN i <-&v~ 7 W c ·tt 0 e S
Integrator: /)t~A¥/'4, -.8n t./ N
Operator Certification Number: Z ~ /S" ..3
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D"
Discharges & Stream Impacts
I . Is any discharge observed from an y part of the operation?
Discharge originated at: 0 Structure D Application Field 0 Other
a . Was the conveyance man-made?
b. Did the discharge reach waters of the Sta te ? (If yes, notify DWQ)
c . What is the estimated volume that reached waters of the State (gallons)?
Longitude:
DYes ~DNA ONE
DYes 0No ~A ONE
DYes 0No ~ONE
I
d. Does discharge bypass the waste management system? (If yes, notify DWQ) DYes 0No ~ONE
DYes ~ DNA ONE
DYes ~DNA ONE
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page I of 3 12/28104 Continued
I Facility Number: 82-~S3 I Date of Inspection IB-Jo-lo I
Waste Collection & Treatment .
4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I
Identifier: # I
Spillway?:
Structure 2 Structure 3 Structure 4
DYes ~DNA ONE
DYes l31'iO DNA ONE
Structure 5 Structure 6
Designed Freeboard (in): ----'7!:"'"------------------------------------
30
,,
Observed Freeboard (in): --l-~-=------------------------------------
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/large trees, severe erosion, seepage, etc .)
6. Are there structures on-site which are not properly addressed and/or managed
through a waste management or closure plan?
DYes ~DNA ONE
DYes ~DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement? 0 Yes ~ DNA D NE
8. Do any ofthe stucturcs lack adequate markers as required by the permit? DYes ~DNA D NE
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
DYes ~DNA ONE
DYes ~DNA ONE
II. Is there evidence of incorrect application? lfyes, check the appropriate box below. DYes ~DNA D NE
D Excessive Ponding D Hydrauli c Overload D Frozen Ground D Heavy Metals (Cu, Zn, etc .)
D PAN D PAN > 10% or 10 lbs 0 Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop Window D Eviden ce of Wind Drift 0 Application Outs ide of Area
12 . Croptype(s) ar61-L4Jkq;t_ b~~ LJ(~ ftw~Vt~.JS
>
13. Soil type(s) Ly
1
Fo.,-e.:s.-fo.v J NoA
1
~oA ) ~
14. Do the receiving crops differ from those desi gnated in theCA WMP? DYes ~DNA ONE
15 . Does the rec eiving crop and/or land application site need improvement? DYes ~DNA ONE
16 . Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination? DYes ~oO NAO NE
17. Does the fa c ility lack adequate acreage fo r land application?
18. Is there a lac k of p roperly operating waste app lic ation equipment?
DYes ~DNA ONE
DYes ~DNA ONE
;,..:..:
YES answers alld/or
12128/04 Continu ed
I Facility Number: fl2 -,631 Date oflnspection Is -10-10 I
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components ofthe CAWMP readily available? If yes, check
the appropriate box. D WUP 0 Checklists D Design D Maps D Other
DYes ~DNA ONE
DYes ~ DNA ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes ~ 0 NA 0 NE
D Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Waste Transfers D Annual Certification
D Rainfall 0 Stocking D Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rai~ gauge? DYes ~DNA ONE
23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes ~DNA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? DYes ~DNA ONE
25. Did the facility fail to conduct a sludge survey as required by the permit? DYes (31:lo"ONA ONE
26. Did the facility fail to have an actively certified operator in charge? DYes ~DNA ONE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes ~DNA ONE
Other Issues
28. Were any additional problems noted which cause non-compliance ofthe permit or CAWMP? DYes ~DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes
and report the mortality rates that were higher than normal?
~DNA ONE
30. At the time of the inspection did the facility pose an odor or air quality concern? DYes ~DNA ONE
If yes, contact a regional Air Quality representative immediately
~DNA 31. Did the facility fail to notify the regional office of emergency situations as required by DYes ONE
General Permit? (ie/ discharge, freeboard problems, over application)
~DNA 32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative? DYes ONE
33. Does facility require a follow-up visit by same agency? DYes ~DNA ONE
Page 3 oj3 12/28104
BIMS /1-2'3-2.ooq
ompliance Inspection 0 Operation Review
Reason for Visit ~tine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access
DateofVisit: l11l·if-o9! Arrival Time:l/0,~.-lh-I Departure Time: ~~j"QA-.. I County: fl._,.s,_ • Region: F~
Farm Name: ~ .v~,cf "1 ~ 2-Owner Email: --------------
Owner Name: {,J "\ V /0.. 1\/ ~ v ..._ Phone:
Mailing Address: -----------------------------------------
Physical Address:-----------------------------------------
Facility Contact: _....;:Ec=_AI_IV_1 ~_---=.t;.l......:..l.:.:li..;..•-.::-=·~J..L... __ Title: ~v'-/f/l 1tr. PhoneNo: ________ _
Oosite Representative: i2v ,..J .-vi "-lch i I/~ &5 Integrator: /11-B
Certified Operator: w:,f, ·~--=J _________ _ Operator Certification Number: __ "2____:'1-~/53:.. __ _
Back-up Operator: G t:..-.ld w~v<---_________ _ Back-up Certification Number: !Cfl¥5
Location of Farm: Latitude: D OD'D" Longitude:
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation? DYes ~DNA ONE
Discharge originated at: 0 Structure D Application Field 0 Other
a. Was the conveyance man-made?
b. Did the discharge reach waters of the State? (If yes, notifY DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
DYes 0No ~A ONE
DYes DNo (3'NA ONE
I
DYes 0No ~ ONE
DYes ~ DNA ONE
DYes ~ DNA ONE
12118104 Continued
j Facility Number: 92-& 831 Date of Inspection 111-t ~-c r
Waste Collection & Treatment
4. Is storage capacity (structural plus stonn storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
DYes ~DNA ONE
DYes l31fo 0 NA 0 NE
Structure 5 Structure 6
Identifier:-----------------------------------------
Spillway?:
Designed Freeboard (in): ·20.4-''
Observed Freeboard (in): ~ 2 7,1)_''-----------------------------
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
6. Arc there structures on-site which are not properly addressed and/or managed
through a waste management or closure plan?
DYes ~DNA ONE
DYes ~o DNA ONE
If any of questions 4-6 were answered yes, and the ~ituation poses an immediate public health or environmental threat, notify DWQ
7. Do any ofthe structures need maintenance or improvement? 0 Yes ErNo 0 NA 0 NE
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
11. Is there evidence of incorrect application? If yes, check the appropriate box below.
DYes ~ DNA ONE
DYes ~DNA ONE
DYes la'No DNA ONE
DYes ~DNA ONE
D Excessive Ponding 0 Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn, etc.)
0 PAN D PAN> 10% or 10 lbs D Total Phosphorus D Failure to Incorporate Manure/Sludge into Bare Soil
D Outside of Acceptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area
12. Crop typc(s) -~C:;!":!l(':.l#!::!....::.......!w~·:.~::~L,.$4+..;;-.__I:r:::._.:::-..J.B.l..:s:::~~ ..... ~,.,;{_-;;--"w~,llJ~N~-f~y,...=!:::k:::___J.k~~"'~"'~J_::::::::::. ______________ _
13. Soil type(s)
14. Do the receiving crops differ from those desi!,'Ilated in theCA WMP? DYes ~DNA ONE
15. Does the receiving crop and/or land application site need improvement? DYes ~DNA ONE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination? DYes ~D NAD NE
17. Does the facility lack adequate acreage for land application?
18. Is there a lack of properly operating waste application equipment?
Reviewer/Inspector Name
Reviewer/Inspector Signature:
DYes [31fo' DNA ONE
DYes ~DNA ONE
Phone: 910 • 'Si83 .3300
Date: 11-19-2.00 9
12118104 Continued
.. . _.. (p~3
I Facility Number: fJ 2 -c;gjl Date of Inspection Vl~t9 -of I
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of the CA WMP readily available? If yes, check
the appropriate box. D WUP D Checklists D Design 0 Maps D Other
DYes ~DNA ONE
DYes ~ DNA ONE
21. Does record keeping need improvement? If yes, check the appropriate box below.
D Waste Application 0 Weekly Freeboard D Waste Analysis D Soil Analysis
DYes ~DNA ONE
D Waste Transfers D Annual Certification
D Rainfall D Stocking D Crop Yield D 120 Minute Inspections D Monthly and 1" Rain Inspections D Weather Code
22. Did the facility fail to install and maintain a rain gauge?
. 23. If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit or CAWMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
33. Does facility require a follow-up visit by same agency?
DYes ~ DNA ONE
DYes ~DNA ONE ~DNA ONE
~0 _,.PNA ONE
DYes ~DNA ONE
DYes ~DNA ONE
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
~ DNA ONE
[3'1(o" DNA ONE
~DNA ONE
~DNA ONE
~DNA ONE
~DNA ONE
12128104
I Facility Number l _rz H ~~?_II G Division of Water Qua li ty
0 Division of S oil a nd Water C onsenation
0 Other Agency
Type of Visit (t Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit • Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other D Denied Access
Da te ofVisit: l12-2!-o1l ArriniTime:l'l!JOA-.1 DepartureTime: l2~~0p.y I County: Ueyt'f!,./ Region: p,tJ..D
Farm Name: K.~tJe-Jj f-ay !'\4. No , Z.. Owner Email: ------------
Owner Name: G!=rg/J LJo..vYW Phone:
Mailing Address: ----------------------------------------
Physical A ddress:----------------------------------------
Facility Conta ct: PhoneNo: ________ _
Onsite Repres entati\•e: lZouNi ~ W." H it:.~ Integrator :----------------
C ertified Operator:--------------------Operator C ertification Number: -------
Back-up Opera to r: --------------------Back-up Certification N umber:
Location or Farm : Latitude: D OD 'D " Longitude: D OD 'D "
D esig n Current Design Current Design Curren t
Swine C apacity Population Wet Poultry Capacity Population C a ttle C apac ity Population
ID Wean t o F inis h I I
0 Wean to Feeder
I~ Feede r to Finis h 35ZO
0 Farrow to Wean
0 Farrow to Feeder
0 Farrow to F in is h
0 Gi lts
0Boars ------
10 Layer
I I .1
0 Dairy Cow
D Dairy Ca lf ' I
I
0 Dairy Heife1 I
0DryCow I
0 Non-Dairy ~
D Beef St ocket ' l
D Beef Feede r I
I
D Beef Brood Cow !
I ----. --
ONon-Layei
Dry Poult ry
D L aye rs
D No n-Lavers '
!
D Pull ets
D Turkeys
Other D T urkey Pou lts '
D o the r Number of Structures: L_~ _j lD Other
Disch a rges & Strea m Impacts
l . Is any discha rge observed from any part of the op erati on? D Yes IJl1 No D NA O NE
Disc harge o ri gin ate d at 0 Stru cture 0 Applicat ion Field D Other
a. Was the conveyance man -made ? D Yes £t1 No D NA O NE
b. Did the disc harge reach wa ters of the State? (If yes, notify DWQ) D Yes ~No D NA O NE
c. What is the est im ated vo lume th at reac hed waters of th e Sta te (gallons)?
d . Does d isc ha rge bypass the was te management system? (If yes, no tify DWQ)
2. Is there evidence of a past discharge rrom any part of th e operation?
3. Were there a ny adverse impacts or potentia l adverse impac t s to the Waters of the Sta te
other tha n fro m a discharge?
D Yes ~No
D Yes qJ No
D Yes ~No
12128104
D N A O NE
D NA O NE
D NA ONE
Continued
l Facil-ity Number: f'Z -6 ~ Date of Inspection l1z-y-c7l
Waste CoUection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall ) less than adequate?
a. I f yes, is waste level into the s tr uctural freeboard?
Structure I Structure2 Structure 3 Structure 4
D Yes ~No DNA ONE
0 Yes I2J No 0 NA ONE
Structure 5 Structure 6
Identifier: --~~t£...--#_9 __ --------------------------------
1-1/Jf Spi llway?:
Desibrned Freeboard (in):-----,.....-----------------------------------
z n-I O bserved Freeboard (in): ~ _ _...::......;:;;;.._ __ _
5. Ate there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe er osion, seep age, etc.)
6. Are there structures on-site w hich are not properly addressed and/or managed
through a waste management or closure plan?
DYes 00No DNA ONE
DYes l1JNo DNA ONE
If a ny of questions 4-6 were ans wered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the s tructures need maintenance or improvement?
8_ Do any of the stuctures Jack adequate marker s as requ ired by the p ermit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
D Yes [lJNo DNA ONE
0 Y cs [1J No 0 NA 0 NE
9. Does any part o f the waste m anagement system other than the waste structures require
maintenance or improvement?
0 Yes f:P No 0 NA 0 NE
Waste Application
I 0. Are there any required bufTc rs, setbacks, or compliance alternatives that need
maintenance/im provement?
DYes ~No DNA ONE
II. Is ther e evi dence of inco rrect appl ication? If yes , check the appropriate box below. 0 Yes O{No 0 NA D NE
0 Excessive Ponding 0 Hydrauli c Overload 0 Frozen Ground 0 H eavy Metals (Cu, Zn, etc.)
0 PAN D PA N> 10% or 10 lb s 0 Total Phosphorus 0 Failure to Incorpo r ate Manure/S ludge into Bare Soil
D Outside of Acceptable Crop Window 0 Evidence of Wind Drift D Applicati o n Outside of Area
12.Cr o ptype(s) CorAl) wb..41, >7heu,.,;5 j .1iilirvk~"J.J
13. Soil type(s) n; boA . L# . /'loB /(CL
I 7 r '
14 . Do the receiving crop s differ from those designated in theCA WMP? D Yes llJNo DNA
15. Does the receiving crop and/or land application si te need improvement? 0 Yes ~No DNA
16 . Did the faci lity fail to secur e and/or operate per th e irrigation design or wettable acre determination?O Yes Of No DNA
17. Does the facility la ck adequate acreage for land application?
18 . Is there a l ack of properly operating waste application equipmen t?
0 Yes f! No
DYes ~No
DNA
DNA
Comments (refer to question #): Explain any YES answers a nd/or any recommendations or any other comments.
Use drawings of facility to bett er explain situations. (usc additional pages as necessary):
q 10 , t/JT· J700
Reviewer/Inspector Name ~ .. <..,~ R €-V( ... .l.~ Phone :~Z7 - 2 tJt:J'1
ReYiewer/lnspector Signature: .R~~~-L Date: /.. z -#-Z.IJ() 7
ONE
ONE
ONE
ONE
ONE
...
1-
f-.....
. 12128104 Continued
I z. -'ZI -"UJ"b I
. . •
l Facility Number: 8'2 -jU I
Required Records & Documents
Date of Inspection l;z-.Z!-07 I
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes, check
the appropirate box. 0 WUP 0 Checklists 0 Design 0 Maps 0 Other
D Yes ~No DNA ONE
DYes reNo D NA O NE
2 I. Does record keeping need improvement? If yes, check the appropriate box below. 0 Yes 9'No 0 NA D NE
0 Waste Application 0 Weekly Freeboard 0 Waste Analysis 0 Soil Analysis 0 Was te Transfers D Annual Certification
0 Rainfall 0 Stocking D Crop Yield 0 120 Minute Inspections 0 Monthly and I" Rain Inspections 0 Weather Code
22. Did the facility fail to install and maintain a rain gauge? DYes ~No DNA ONE
23. I f selected, did the facility fail to install and maintain rainbreakers on irrigation equipment? DYes !1No DNA ONE
24. Did the facility fail to calibrate waste application equipment as required by the permit? D Yes £]'No DNA ONE
25. Did the facility fail to conduct a sludge survey as required by the permit? DYes ~No DNA ONE
26. Did th e fa ci lity fail to have an actively certified operator in charge? D Yes ~fJNo DNA O NE
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification? DYes lf1No DNA ONE
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP? DYes ~No DNA ONE
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document DYes ~No DNA ONE
and report the mortality rates that were higher than norm al?
30. At the time of the inspection did the facility pose an odor or air quality concern? DYes ~No DNA ONE
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notifY the re gional office of emergency situations as required by DYes ~No DNA ONE
General Pe rmit? (ie/ discharge, freeboard problems, over appli catio n)
32. Did Reviewer/Inspec tor fail to discuss review/inspection with an on-site representative? D Yes ~No DNA O NE
33. Does facility require a follow-up visit by same agen cy? DYes ~No DNA O NE
Additional Comments and/or Drawings:
....
t--
-•
11/28104
_,
Type of Visit 8 Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit e Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other 0 Denied Access
Region: DateofVisit: I ~-.25-~J Arrival Timed ?:20Ad DepartureTime: lf'f3?ml County:
Farm Name: Ke!VtJe.c:J) l=t:Z~rHA No, 2.. OwnerEmail: ------------
OwnerName: GGarld h.Ja.rY~d Phone:
Mailing Address: -----------------------------------------
Physical Address:------------------------------------____ _
Facility Contact: _ /5~~0"":........;...N......;I_;' <-=-....;.:·ivf-=.!....i'l.~..:.'k=a..:...;"""-=s _Title: -"-h_a..;;...:¥;...;~;..;.....:..___,11/.~~~y_., __ Phone No:---------
Onsite Representative: --'~c.......=.....:O:....:Nc.::....:.IV~i...:-<-=-_..;;·/J.=.J,'-=-' I.LJtui:..:~=....S....i£... _____ _ Integrator:----~-----.;;._.....;...----:---
Certified Operator:--------------------Operator Certification Number: ----.....,....--
Back-up Operator: --------------------Back-up Certification Number:
Location of Farm: Latitude: D OD'D" Longitude:
Discharges & Stream Impacts
I. Is any discharge observed from any part of the operation? DYes l,lJ No 0 NA D NE
Discharge originated at: 0 Structure D Application Field 0 Other
a. Was the conveyance man-made?
b . Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
d. Does discharge bypass the waste management system? (Jfyes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
Page 1 of3
DYes [5?No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ~No DNA ONE
DYes ijlNo DNA ONE
12/18104 Continued
-·
I Faci~ty Number: ~Z -4:, 831 Date of Inspection
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structur:V Structure 2 Structure 3
Identifier: L~"L-!1_ .,
Structure 4
Spillway?:
DYes ~No DNA ONE
DYes [j)No DNA 0 NE
Structure 5 Structure 6
Designed Freeboard (in):---------------------------------------
32 ,,
Observed Freeboard (in):--...:=::.-=------------------------------------
5. Are there any immediate threats to the integrity of any of the structures observed?
(ie/ large trees, severe erosion, seepage, etc.)
DYes l}lNo DNA 0 NE
6. Are there structures on-site which are not properly addressed and/or managed
through a waste management or closure plan?
DYes 9i~No DNA ONE
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any of the structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the pennit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part ofthe waste management system other than the waste structures require
maintenance or improvement?
Waste Application
I 0. Are there any required butlers, setbacks, or compliance alternatives that need
maintenance/improvement?
0 Yes II' No 0 NA 0 NE
DYes !&)No DNA ONE
DYes ~No DNA ONE
DYes 'fiNo DNA ONE
1 L Is there evidence of incorrect application? If yes, check the appropriate box below. 0 Yes ~No 0 NA 0 NE
0 Excessive Ponding D Hydraulic Overload D Frozen Gro und 0 Heavy Metals (Cu, Zn, etc.)
0 PAN 0 PAN > 10% or 10 lbs D Total Phosphorus 0 Failure to Incorporate Manure/Sludge into Bare Soil
0 Outside of Acceptable Crop W indow D Evidence of Wind Drift D Application Outside of Area
12. Croptype(s) 5JHqt/ r;Yfl.l~
1
&rA/ 1 w/,<A I, 57.h~~T.IV..J
13. Soil type(s) ra Go A-) LN", )./ o & R o....
/ 7 J
14. Do the receiving crops differ from those designated in the CAWMP? 0 Yes I5?JNo 0 NA D NE
15. Does the receiving crop and/or land application site need improvement? 0 Yes IKJ No DNA 0 NE
16. Did the facility fail to secure and/or operate per the irrigation design or wettable ac re determination ? D Yes ~ No D N~ 0 NE
17. Does the facility lack adequate ac reage for land appli cation? DYes ~No DNA 0 NE
18. Is there a lack of properly ope rating waste application equipment? DYes If' No 0 NA D NE
co,ID~n~i~~~;~!r~r· to question #): Explain any re(:ontm,emlationls.
dri!wiiili!iiof facility to better explain situaJtio:os:;i(use ::lld(l.iti.o·n:al pages as ne1c-essar-y
Reviewer/Inspector Name
Reviewer/1 nspector Signature:
Page 1 of3 12128104 Continued
I Facility Number: ~2 -~8.>1 Date of Inspection lp~l
Required Records & Documents
19. Did the facility fail to have Certificate of Coverage & Permit readily available?
20. Does the facility fail to have all components of theCA WMP readily available? If yes , check
the appropriate box. 0 WUP D Checklists D Design 0 Maps 0 Other
DYes [)No DNA ONE
DYes ~No DNA ONE
21. Does record keeping need improvement? If yes, check the appropriate box below. DYes ~No DNA D NE
0 Waste Application D Weekly Freeboard 0 Waste Analysis 0 Soil Analysis D Waste Transfers 0 Annual Certification
0 Rainfall 0 Stocking D Crop Yield D 120 Minute Inspections D Monthly and 1" Rain Inspections 0 Weather Code
22 . Did the facility fail to install and maintain a rain gauge?
23 . If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as requ ired by the permit?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27 . Did the facility fail to secure a phosphorus Joss assessment (PLAT) certification?
Other Issues
28 . Were any additional problems noted which cause non-compliance of the permit orCA WMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31 . Did the facility fail to notify the regional office of emergency situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32 . Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
33 . Does facility require a follow-up visit by same agency?
!\dditio~al;coiomcn~·and/or Drawings:
Page3of3
DYes QgNo DNA ONE
DYes ~No DNA ONE
DYes O(No DNA ONE
DYes [BINo DNA ONE
DYes i3No DNA ONE
DYes (d!No DNA ONE
D Yes ~No DNA ONE
D Yes ~No DNA ONE
DYes ~No DNA ONE
DYes [)lNo DNA ONE
DYes ~No DNA ONE
DYes t'iJNo DNA ONE
,. ~ --~·!-'.j·t·f:~ .. :ii~tf?~~~~;: .. : -~~~~~~~~~f£1~;; .. : .. :·.::·:~-~~-~
.... r--
-.....
12128104
• � Division of Water Quality r '�.��,
r Faeft Number,) n Gr O Division of Soil and Water Conservation Kl ay F'
0 OtherAgency ;.y.
a
Type of Visit • Compliance Inspection 0 Operation Review 0 Structure Evaluation 0 Technical Assistance
Reason for Visit 0 Routine 0 Complaint 0 Follow up 0 Referral 0 Emergency 0 Other ❑ Denied Access
i
5
Date of visit: D• 77of Arrival Time: S Departure Time: County: Ai95en Region:
Farm Name: Kenn rim Owner Email:
Owner Name: Lt/grirn '�G cInt. / Phone: rl/� STdir
Mailing Address: P. O. 60X -2-73 Nem Gro✓e �L_703 4wa_
Physical Address:
Facility Contact:—LISO.D-C G/'1J`aw+j Title:
Onsite Representative: _1S.Oan�G��%kn.5
Certified Operator: Ger /of
Back-up Operator:
Location of Farm:
Swine
Other
❑ Other
Latitude:
Phone No:
Integrator:
Operator Certification Number: 19/ells—
Back-up Certification Number:
[:D =°=` ="
Design Current Design Current
Capacity Population Wet Poultry Capacity Population
❑ Laver
❑ Non -Lave[
Dry Poultry
❑ Layers
❑ Non -Layers
❑ Pullets
❑ Turkeys
❑ Turkey Pocks
❑ Other
Discharges & Stream Impacts
I. Is any discharge observed from any pan of the operation'?
Discharge originated ac ❑ Structure ❑ Application Field ❑ Other
a. Was the conveyance man-made'?
Design Current
Cattle Capacity Population
❑ Dairy Cow
E3Dairy Calf
❑ Dairy Heifer
❑ Dry Cow
❑ Non -Dairy
❑ Beef Stocker
❑ Beef Feeder
❑ Beef Brood Co
b. Did the discharge reach waters of the State? (If yes, notify DWQ)
c. What is the estimated volume that reached waters of the State (gallons)?
Number of Structures:
d. Does discharge bypass the waste management system? (If yes, notify DWQ)
2. Is there evidence of a past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State
other than from a discharge?
❑ Yes �No ❑ NA EINE
❑ Yes
❑ No
❑ NA
❑ NE
❑ Yes
❑ No
❑ NA
❑ NE
❑ NA
❑ NE
❑ Yes
❑ No
❑ Yes
E?No
❑ NA
❑ NE
❑ Yes
u No
❑ NA
❑ NE
12/28/04 Continued

l Facility N•umber: 8.). -/:;. £ Date of Inspection I ;J ·li-b) I
Waste Collection & Treatment
4. Is storage capacity (structural plus storm storage plus heavy rainfall) less than adequate?
a. If yes, is waste level into the structural freeboard?
Structure I Structure 2 Structure 3 Structure 4
0 Yes [d"No DNA D NE
DYes ca-No DNA ONE
Structure 5 Structure 6
Identifier: ---.L...------------------------------------
Spillway?: flO
Designed Freeboard (in): --="::J=e>~._.lf"--'' __ ----------------------------------
Observed Freeboard (in): __ 3......,J..._"_"' ___ ----------------------------'-------
5. Are there any immediate threats to the integrity of any of the structures observed? DYes ld'No DNA ONE
(ie/ large trees, severe erosion, seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed DYes l3'No DNA ONE
through a waste management or closure plan?
If any of questions 4-6 were answered yes, and the situation poses an immediate public health or environmental threat, notify DWQ
7. Do any ofthe structures need maintenance or improvement?
8. Do any of the stuctures lack adequate markers as required by the permit?
(Not applicable to roofed pits, dry stacks and/or wet stacks)
9. Does any part of the waste management system other than the waste structures require
maintenance or improvement?
Waste Application
10. Are there any required buffers, setbacks, or compliance alternatives that need
maintenance/improvement?
II. Is there evidence of incorrect application? If yes, check the appropriate box below.
DYes 0'No DNA ONE
0 Yes Gf"No 0 NA 0 NE
DYes l:a'No DNA ONE
DYes l3'No DNA D NE
DYes B'No DNA ONE
0 Ex cess iv e Ponding D Hydraulic Overload 0 Frozen Ground 0 Heavy Metals (Cu, Zn , etc.)
D PAN D PAN > 10% or 10 lbs 0 Total Phosphorus D Failure to Incorporate Manure/Sl udge into Bare Soil
0 Outside of Acce ptable Crop Window 0 Evidence of Wind Drift 0 Application Outside of Area
1 ;:J ?r ::>=-~ 3 ~ ..-l•o ']r>r ~0 /) ~ , .. ,,
12 . Crop type(s) IJcrmu,l,. Hoy S,aJ/ 6;,.9 ;0 Hth ...
f /
13. Soi I type( s) Ly, cl4,, 1 ,fq,',s; GJtlst,, J
14. Do the receiving crops differ from those designate d in theCA WMP? DYes ~o DNA ONE
15 . Does th e receiving crop and/or land application site need improvement? Q-y es D No D NA 0 NE
16 . Did the facility fail to secure and/or operate per the irrigation design or wettable acre determination!D Yes D No DNA ~
17. Does the facility lack adequate acreage fo r land application?
18. Is there a la ck of properly operating waste application equipment?
Reviewer/Inspector Name
Reviewer/In specto r Signature:
.... :1~ _,,. * 1 s: i;
DYes D No 0 NA l:d1'm
DYes Q1<l"o DNA ONE
Phone: 'tlcJ·ldf.r·I>M ~,f ">lo
Date :
12128104 Continued
. ..
I Facility Number: 8:;. -t:z.s-1
Required Records & Documents
Oate of I nspcction !.2 -Ill -oil
19. Did the facility fail to have Certificate of Coverage & Pennit readily available?
20. Does the facility fail to have all components of the CAWMP readily available? If yes, check
the appropirate box. D ~D c~ D D~ D~ 0 O)l:ter"
0 Yes G31fo 0 NA 0 NE
DYes ~o DNA ONE
~s 0No DNA ONE 21. Does record keeping need improvement? If yes, check the appropriate box below .
.:;2 ·f8-, ''6 l-Is-:> I.<..
Ww"aste Application \llew-1::· hi>i>l?~;ud D Waste Analysis D Seil .\rldi)St!! 0 \lt'astc Ttansfcts D Annual Certification
D ~ 0 .&$..-:>chRg B'Crop Yield G31"20 Minute Inspections D r..~sHti:!ly aHfi l" Rain Inspections ~eather Code
22. Did the facility fail to install and maintain a rain gauge?
23. If selected, did the facility fail to install and maintain rain breakers on irrigation equipment?
24. Did the facility fail to calibrate waste application equipment as required by the permit'?
25. Did the facility fail to conduct a sludge survey as required by the permit?
26. Did the facility fail to have an actively certified operator in charge?
27. Did the facility fail to secure a phosphorus loss assessment (PLAT) certification?
Other Issues
28. Were any additional problems noted which cause non-compliance of the permit orCA WMP?
29. Did the facility fail to properly dispose of dead animals within 24 hours and/or document
and report the mortality rates that were higher than normal?
30. At the time of the inspection did the facility pose an odor or air quality concern?
If yes, contact a regional Air Quality representative immediately
31. Did the facility fail to notify the regional office of t:mergcncy situations as required by
General Permit? (ie/ discharge, freeboard problems, over application)
32. Did Reviewer/Inspector fail to discuss review/inspection with an on-site representative?
33. Does facility require a follow-up visit by same agency?
Additional Comment,s aiidJor. Drawings:
..
-t:J lr
7;,., HA'' -Cf;o-3 :J'-I--tt'1 ;;r
I< :cit f1o,.,.:s -Cf /1:1, Bt./,-s-tr~s-
r,,
DYes 131\fo DNA ONE
DYes 0'No DNA ONE
DYes ~0 DNA ONE
DYes G;}-No DNA ONE
DYes ~0 DNA ONE
DYes 0No DNA !2rNE
DYes 0No DNA ONE
DYes 0"'No DNA ONE
DYes 0"No DNA ONE
0 Yes GrNo DNA ONE
DYes ~ DNA ONE
DYes 0'No DNA ONE
,, 1-J. t r: ~{e) . PJ 'Q.s e c ,"( ·d {;_, Half or 1?.-~k .IH~,,;J 4b~ .. + « ;
'17/' t! ~-{' C~S~t>t( fS t'r-.,./,. f/, ,.-/-
&< e.ve?lr~ -1-r Pt' s "'· /.
12118/04
~"'nrnnlii .. n•• .. Inspection 0 Operation Review 0 Lagoon Evaluation
Reason tor Visit 0-f'{outine 0 Complaint 0 Follow up 0 Emergency Notification 0 Other D Denied Access
FacilityNumber 1 }J'J. H {pf$ 1 IDateofVisit: I t/tJ'-/orfiTune: I /9: 1o I
""---------------------~-lo Not Operational 0 Below Threshold
El-Permitted [ii-Certified C Conditionally Certified C Registered Date Last Operated or Above Threshold: -------·
Farm Name: ··-·----~~~----····£~~---···-~~-----··-----·-··--·-·-·-·-·-County: ----~5!!!.~-------·---···-··----·-·--·
Owner Name: ... ---~-~f!!':L ___ .fu~. :·7···--C~~-----·-----·--·-.. Phone No: __ 5..~1.:..L? o/_ ________________________ _
Mailing Address: ··--P:-~.:.·----~~----·-··-;!-~_l__·--···-·-·---·--·---·-·-·-·-·-__ .f...(~----f.~---/Y_?__________ ···-~---
Facility Contact: ..... _.&.n.ic.. .. -.. ·····-··-~-~-~~~-~-~---·-·-·-Title: ··-····--~~~f?:..···············--···-·-·· Phone No: -·--·---·-·-·--------···
Onsite Representative: ··-·-····-····f?.f?.!4~.!.!': ___________ _l~i!~~~---·--·-··--·-··... Integrator: ___ /r.J#.!.~~-L~.!-~!n.._S~J::J_
Certified Operator: ........... _g~!.~ ...... ~---·····-·-·· --~iJ1!.~6~---·-···-······-·-···-··· Operator Certification N~ber: ·--~-~.!?..~---··-·-·-·
Location of Fann:
6J-Swine D Poultry D Cattle O Horse Latitude '---_,1• ~-.I _---..~1' ~-.I _ __.f" Longitude
··-
~Wine '..::.".!:~---
eeder to Finish ~$''-0
Farrow to Feeder
Discharges & Stream Impacts
1. Is any discharge observed from any part of the operation?
Discharge originated at D Lagoon 0 Spray Field 0 Other
a. If discharge is observed, was the conveyance man-made?
b. If discharge is observed, did it reach Water of the State? (If yes, notify DWQ)
c. If discharge is observed, what is the estimated flow in gaUrnin?
d. Does discharge bypass a lagoon system? (If yes, notify DWQ}
2. Is there evidence of past discharge from any part of the operation?
3. Were there any adverse impacts or potential adverse impacts to the Waters of the State other than from a discharge?
Waste CoUection & Treatment
4. Is storage capacity (freeboard plus storm storage) less than adequate? D Spillway
Identifier:
Freeboard (inches):
12112103
Structure 1
I
Structure2 Structure 3 Structure 4 Structure 5
DYes~
DYes 0No
DYes DNo
DYes DNo
DYes ~
DYes QoNo
DYes ~
Srructure 6
Continued
~Facility Number: 93 -{;~~I Dateoflnspection l 9Jil/qt.fl
5. Are there any immediate threats to the integrity of any of the structures observed? (ie/ trees, severe erosion,
seepage, etc.)
6. Are there structures on-site which are not properly addressed and/or managed through a waste management or
closure plan?
(If any of questions 4-6 was answered yes, and the situation poses an
immediate public health or environmental threat, notify DWQ)
7. Do any of the structures need maintenance/improvement?
8. Does any part of the waste management system other than waste structures require maintenance/improvement?
9. Do any stuctures lack adequate, gauged markers with required maximum and minimum liquid level
elevation markings?
Waste Aoplication
10. Are there any buffers that need maintenance/improvement?
II. Is there evidence of over application? If yes, check the appropriate box below.
D Excessive Ponding D PAN 0 Hydraulic Overload 0 Frozen Ground 0 Copper and/or Zinc
12. Croptype &_!o..,___l; qt :" ...,J.,..'h'~
13. Do the receiving crops differ With those designated in the Certified Animal Waste Management Plan (CA WMP)?
14. a) Does the facility lack adequate acreage for land application?
b) Does the facility need a wettable acre determination?
c) This facility is pended for a wettable acre determination?
15. Does the receiving crop need improvement? b") <'t5f .. ;jr,J
16. Is there a lack of adequate waste application equipment?
Odor Issues
17. Does the discharge pipe from the confinement building to the storage pond or lagoon fail to discharge atlor below
liquid level of lagoon or storage pond with no agitation?
18. Are there any dead animals not disposed of properly within 24 hours?
I 9. Is there any evidence of wind drift during land application? (i.e. residue on neighboring vegetation, asphalt,
roads, building structure, and/or public property)
20. At the time of the inspection did the facility pose an odor or air quality concern? If yes, contact a regional
Air Quality representative immediately.
-sr, 4!.1l>< '-') ~-:yJ J,.., ""' ,_J i'"l.le-.!>
-t,4,rlt k·~ J.vt. .,,, tt.tlle +•~ --to a.......,l~~
-lr.ylOV\ p.-.~~ ~ k.ev. ~t-~ 1' """0\,-t,l J /o.J<., 'ODd
Reviewer/Inspector Name
Reviewer/Inspector Signature:
12112103
DYes ifNo
DYes ~0
DYes [B'No
DYes ifNo
DYes ~0
DYes [Q1Cfo
DYes fi21"No
DYes ~0
DYes ~0
DYes [g'No
DYes ~0
DYes [!(No
DYes ~0
DYes [3'No
DYes ~
DYes ~0
DYes ~0
ConJinued
··I Facility Number: i;z. -"~~ Date of Inspection I • tfb'JOH.
Required Records & Documents
21 . Fail to have Cenificate of Coverage & General Permit or other Permit readily available?
22 . Does the facility fail to have all components of the Certified Animal Waste Management Plan readily available?
(iel WUP, checklists, design, maps, etc.)
23. Does record keeping need improvement? If yes , check the appropriate box below.
D Waste Application D Freeboard D Waste Analysis 0 Soil Sampling
24. Is facility not in compliance with any applicable setback criteria in effect at the time of design?
25. Did the facility fail to have a actively certified operator in charge?
26. Fail to notify regional DWQ of emergency situations as required by General Permit?
(iel discharge, freeboard problems, over application)
27. Did Reviewer/Inspector fail to discuss reviewfmspection with on-site representative?
28. Does facility require a follow-up visit by same agency?
29. Were any additional problems noted which cause noncompliance of the Certified A WMP?
NPDES Permitted Facilities
30. Is the facility covered under a NPDES Permit? (If no, skip questions 31-35)
31 . If selected, did the facility fail to install and maintain rainbreakers on irrigation equipment?
32 . Did the facility fail to install and maintain a rain gauge?
33 . Did the facility fail to conduct an annual sludge survey?
34 . Did the facility fail to calibrate waste application equipment?
35 . Does record keeping for NPDES required forms need improvement? If yes, check the appropriate box below.
D Stocking Form D Crop Yield Form D Rainfall 0 Inspection After I" Rain
D 120 Minute Inspections 0 Annual Certification Form
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
DYes
~es
DYes
DYes
DYes
DYes
DYes
11!1' No violations or deficiencies were noted during this visit. You will receive no further correspondence about this visit.
--iJ;~,P~ ~ckluJ
ltl ~Is Q ~. 1
12/12103
~0
~0
[iJ..N()"
g-NO
~No
ElNo
[31'lo
[B"No
r;;rNo
ONo
9-No
~0
~0
~0
~0
....
t--
0 DSWC Animal Feedlot Operation Review
• DWQ Animal Feedlot Operation Site Inspection
0 Follnw-u l'<=tion 0 Other
Date of Inspection I f-2 -~21
Facility Number
Time of Inspection 115 :.-o I Z4 hr. (hh:mm)
[]Registered • Certified []Applied ror Permit []Permitted lc Not Operational I Date Last Operated: ......................... .
Farm Name' ___ ].k.,~~-&,(~-~::-_?,)______ County, ---~-=:,!._ ____________ ------------·
Owner Name: ... &~ ... ~~~....................................................... Phone No: .:(?.(.~ ..... ~ .. 'l..!... ... ~ .. .f/ .. 3 .. Y.. ............. .
Facility Contact: .... /J..~ .... ~~ ........ Title: ................................................................ Phone No: ................................................. ..
Mailing Address: ......... E. ... f?.-: ... &~.tj ...... A/~.~-1-.. &!.. ~ ......... :,gf.:_tJ..?.F.: .............................................. ~ ......... ~ ....
Onsitc Representati,•e: ...... ~~ .... /~~~..................................... Integrator: ... ~.~-~ ... : ...
Certitied Operator~ ............ ~ .... ~~...................................... Operator Certification Number~: .... /f:/. .. ?..K.. ....... ..
Location of Farm:
Latitude I I• ._I _ _.I· ._I _......~I" Longitude I• .__I ___.I , .__I ____.I "
Design Current . Design . Current Design Current ;
. Swine Capacity Population Poultry .. Capacity Population Cattle Capacity Population . I§ ~:~~Dairy' . I . ,.: .. 0 Wean to Feeder
• Feeder to Finish
D Farrow to Feeder
D Farrow to Finish
D Gilts
0 Boars
ID Other
Total Design Capacity I
T~tal SSL W : I
'.
. '
;, :Ni~~~t~(i~goo,ns)Holdin~ Ponds Ll __ ____,../<.,-_~liD Subsurface Drains Present no Lagoon Area ID Spray Field Area ~~
~·0: ,"\ ·~ • ,.:·;: ,·::: .. · ,.. .·· . !D No Liquid Waste Management System [~: I<~~~:;·,::~:~;·§~~:~·:r~t~
General
I. Are there any buffers that need rnaintcnancc/improvemenl'?
2. Is any discharge observed from any part of the operation?
Di;;charge originatt:d <.tt: 0 Lagoon 0 Spray Field D Other
a. If dis c harge is obst:rved, \Vas the conveyance man-maJe?
b. If discharge is c>bscrvcd. did it reach Surfa~·c Water? (If yes. notify DWQ )
c. If di scharge is observed, what is the estimated flow in gal/min?
d. Does discharge bypass a lagoon system? (If yes. notify DWQ)
3. Is there evidence of past discharge from any part of the operation?
4. Were there any adverse impacts to the waters of the State other than from a discharge?
5. Does any part of the waste management system (other than lagoons/holding ponds) require
maintenan ce/improvement?
6 . Is facility not in compliance with any appli cable setbac k criteria in effec t at the time of desig n'!
7. Did the facility fail to have a certified operator in responsible c harge?
7/25/97
DYes ~No
DYes ~No
DYes fXl No
DYes I!J.No
DYes ,KJ No
DYes p,«No
DYes ~No .
DYes ~No
DYes a No
I
DYes ~No
Continued on back
I Facili~ Number: 6>2...-c("9t1j
8. Are there lagoons or storage ponds on site which need to be properly closed'!
Structures lLa~oons.Holdin&: Ponds. Flush Pits. etc. I
9. Is storage capacity (freeboard plus storm storage) less than adequate?
Structure 1 Structure 2 Structure 3 Structur~ -1-
Identifier:
DYe.~ ~No
DYes gj No
Structure 5 Structure 6
Freeboard (ft): .....•.... !!:.././~ ................................................................. : ................................................................................................................. ..
10. Is seepage observed from any of the structures?
II. Is erosion, or any other threats to the integrity of any of the structures observed?
12. Do any of the structures need maintenance/improvement?
(If any of questions 9-12 was ans.wered yes, and the situation poses
an immediate public health or environmental threat, notify DWQ)
13. Do any of the structures Jack adequate minimum or maximum liquid level markers?
Wa..,te Applkation
14. Is there physical evidence of over application?
(If in excess of WMP, or runoff entering waters of the State, notify DWQ)
DYes Iii No
SYes [J No
~Yes E]No
DYes JSi!No
DYes ~No
15. Crop type ... h~r·--~7 ... ~~,;;;. ............................................................................................................ : ........................ .
16. Do the receiving crops differ with those designated in the Animal Wa.~tc Management Plan (A WMP)? DYes 81 No
17. Does the facility have a lack of adequate acreage for land application'!
18. Does the receiving crop need improvement?
19. Is there a lack of available waste application equipment?
20. Does facility require a follow-up visit by same agency?
21. Did Reviewer/Inspector fail to discuss review/inspection with un-site representative?
22. Does record keeping need improvement?
For Certified or Pt:mlitted Facilities Onlv
23. Does the facility fail to have a copy of the Animal Waste Management Plan readily available?
24. Were any additional problems noted which cause noncompliance of the Certified A WMP?
25. Were any additional problems noted which cause noncompliance of the Permit?
DYes KJNo
J)(Yes ElNo
~ 18(No
0 Yes lSJ No
0 Yes -I)}No
0 Yes it No
0 Yes 18No
DYes ~No
DYes JXl No
~. ~~ :vi~Iatio~s. o_r _de~cieitdes were· noted duri_n¢ this: ~isit. ~ You \\;ill nice_ive no ftirt~ier~: ·
~ :. corres"pondence about this. visit. . ' ' . . . . ' ' . . . .
7/25/97 1-.....
Reviewer/Inspector Name ~: I'::-;.: j',iL;#-,(::': ;~~£--·:~·----:./ .. ~~--;;···,·::~:::;_·: ,.,_ . ..., .--.. ~
·.1 __ ..,.<"-.,.~ ~ ' I
Reviewer/Inspector Signature: ~__/_._r-L _a_~ Date: ~-2C-97
'